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LCA-DFW CHECK REQUEST FORM
Liberian Community Association of Dallas/Fort Worth Metroplex
www.lcadfwmetro.org P.O. Box 300133, Arlington TX 76007 Cell#: 817- 504-8252
CHECK REQUEST FORM (REQUESTER FILLS IN THIS SECTION)
Date of request:
Person requesting:
Requester’s phone number:
Requester’s Email:
Make check payable to:
Amount of check: $
Purpose:
Electronic Signature of requester
___________________________________________________________________________________________
Financial Secretary Signature
____________________________________________________________________________________________
Note: Prior approval must be obtained on all purchases. Failure to obtain approval may result in purchaser having to incur the expenses. If item has already been purchased, please attach receipt(s) to this form. Otherwise, provide receipt(s ) as soon as possible after purchase. Signature of the LCA-DFW president is required before treasurer will issue check.
___________________________________________________________________________________________
President’s Signature
Date:
___________________________________________________________________________________________
FOR TREASURER`S USE ONLY

Date issued
Check number
Charged to what budget item
Comments
Treasurer’s signature
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